The robotic Trunk-Support-Trainer (TruST) to measure and increase postural workspace during sitting in people with spinal cord injury

Spinal Cord Series and Cases, 2020 · DOI: https://doi.org/10.1038/s41394-019-0245-1 · Published: January 1, 2020

Spinal Cord Injury Assistive Technology Rehabilitation

Simple Explanation

This study introduces the robotic Trunk-Support-Trainer (TruST) device. TruST is designed to measure the sitting workspace area and postural control limits in individuals with spinal cord injury (SCI). The device applies forces to the torso during upper body movements. This force is applied when users move beyond their postural stability limits while sitting. The research investigates if TruST-delivered force fields can expand the active sitting workspace of SCI patients. This expansion occurs beyond their typical postural control limits.

Study Duration

Not specified

Participants

5 (Males = 2, Females = 3) participants with SCI

Evidence Level

Cross-sectional study

Key Findings

1
TruST accurately defines and expands the active seated workspace of people with SCI. This expansion occurs during volitional trunk movements.
2
Participants improved their trunk excursions to posterior, right, and left directions with TruST-force field. The force field provided continuous feedback at the user’s postural limits.
3
The application of TruST-force ﬁeld had a large effect size to increase the maximal trunk excursion towards right (Mean: 3.1 ± SE: 1.1 cm, t(4) = 2.92, p = 0.04, Cohen’s d: 0.90), left (Mean: 5.0 ± SE: 1.7 cm, t(4) = 2.75, p = 0.05, Cohen’s d: 1.5), and posterior (Mean: 5.1 ± SE: 0.8 cm, t(4) = 2.92, p < 0.01, Cohen’s d: 0.72) directions.

Research Summary

The study explores the use of the Trunk-Support-Trainer (TruST) to assess and enhance the active sitting workspace of people with thoracic-lumbar SCI. TruST can objectively measure seated trunk control and define the sitting workspace of individuals with SCI. TruST can substantially expand the sitting workspace area and increase the active seated trunk excursions of people with SCI. This is achieved through force feedback tailored to the person’s postural stability limits during trunk movements. The TruST-force field is progressively implemented within and beyond the sitting control boundaries. This assists in the active control of the trunk and expands the sitting workspace of people with SCI.

Practical Implications

Rehabilitation Tool

TruST shows promise as a rehabilitation tool to implement efficient goal-oriented seated training interventions for individuals with SCI.

Motor Learning

The device can be used to implement motor learning-based paradigms to retrain functional sitting in people with SCI, potentially maximizing the outcomes of motor learning-based programs.

Personalized Therapy

TruST allows for personalized force-feedback at the user’s postural limits, which opens new frontiers to maximize trunk movements beyond the postural control limits.

Study Limitations

1
Small sample size with unbalanced male:female ratio.
2
Heterogeneous demographics and clinical features of participants.
3
Some participants showed motor deficits to overcome the TruST-force field at the maximum trunk excursion point of some specific directions.

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